Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024178061 | VA |
NPI | 1033752738 |
---|---|
Provider Name | Katherine Wood |
First Address | Rocky Mount, VA 24151-5893 |
Second Address | Roanoke, VA 24014-1838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2019 |
Last Update Date | 15/07/2021 |